Coping with Colic
Arriving home from the hospital with their newborn daughter,
Shoshanna and Jon were both overjoyed and overwhelmed. The couple anticipated
the happiness they would feel for this very wanted baby, but they were
shocked by how hard it was to transition from a duo to a trio.
Coping with colic taxes the whole family system. The piercing cry of a baby with colic is a disturbing sound. In fact, the sound of a colicky cry has been studied and found to be a more distressing cry than that of a baby without colic.
A study in Child Development finds that colicky infants produced cries at frequencies of more than twenty one hundred hertz or nearly 25% greater frequency than non colicky babies. According to a recent article in The New Yorker, “The sound of a crying baby is just about the most disturbing, demanding, shattering noise we can hear. The United States military has reportedly used the sound of wailing infants as an instrument of psychological stress, piping recordings…into the cells of detainees at Guantanamo Bay.” If it’s stressful to listen to the noise of an unknown baby crying, one can only imagine how much more stressful it is to hear one’s own child crying inconsolably.
New treatment of colic acknowledges that the baby’s symptoms do not happen in a vacuum. At the colic clinic at Brown Center for the Study of Children at Risk they have found that it’s critical to examine not only how colic affects the baby but how it impacts the parent-child relationship. While colic usually diminishes between 2 and 6 months of age, the impact that it can have on a parent child relationship can be lasting.
Parents are often filled with self doubt and guilt about their basic abilities to nurture and provide comfort for baby with colic. It can be especially difficult for parents to stop themselves from wondering if they are doing something wrong when they may be surrounded by friends or family who have “easy” babies.
Moreover, research indicates that parents of colicky babies are at risk for depression. It can feel not only exhausting but also isolating to be alone in the experience of parenting a difficult to sooth infant. This emotional isolation, coupled with feelings of self -consciousness about taking a crying baby out in public, causes many parents of colicky babies to become physically isolated. Unfortunately, they tend to withdraw at the very times when they need the most support.
Dr. Linda Palmer, author of Baby Matters, shares more about this problem and some possible solutions.
Interview with Dr. Linda Palmer:
Baby Maven: What is Colic?
Dr. Palmer: Colic is simply excessive, inconsolable crying in a young baby. Historically, it has been defined as crying for more than 3 hours a day at least 3 days a week for at least 3 weeks in a row.(1) If a baby stops crying when it is picked up, fed, or a wet diaper removed, this is not colic.
When a baby is crying excessively parents and health care practitioners will want to evaluate why? The most common cause for colic is intestinal upset due to intolerance of cow’s milk proteins or other food proteins in mother’s milk or formula.
Baby Maven: What is the difference between Colic and Reflux or GERD?
Dr. Palmer: Today many crying babies are diagnosed with GERD (gastro esophageal reflux disease) and prescribed the new proton pump inhibitor drugs. Current studies reveal that there is not enough standardization used to diagnose GERD and that while the drugs will reduce acid in the stomach and esophagus they do not reduce baby’s colic symptoms or other symptoms. In addition, GERD drugs increase intestinal infections and pneumonia.
Baby Maven: In your book, Baby Matters, you talk about how Colic may be related to diet. Can you tell us what parents can try to help their babies?
Dr. Palmer: Once their child has been examined for uncommon disorders, parents need to decide whether baby has any of the usual symptoms of food intolerance: bouts of loose stools, excessive gas or spitting up, rashes, fussing at the breast or refusing feeds, blood in stools, green stools (bile) or black in stools (digested blood), sleeplessness or waking with screams, arching back, stuffiness or excessive mucus. Sometimes constipation is a symptom as well.
If baby has any of these signs, or baby is just apparently in pain and parents can find no other cause, parents will want to first try removing all dairy proteins from the child’s diet. If baby is breastfed, mother will need to read ingredients of all foods she consumes and look for casein, whey, butter or cream (trace proteins remain), cheese, etc. Some of the most often misunderstood foods are those labeled “non-dairy.” These are simply lactose-free yet and are usually full of milk protein.
There’s a really big bonus for a mom doing an elimination diet. Concurring with the fact that food intolerance is often hereditary, at least half of my moms mention having found answers to their own digestive tract challenges through elimination dieting for baby, even though they seldom disclose these complaints to me at the onset of our collaboration.
If baby is formula fed, a switch from milk formula to soy formula is the first step, followed by a try of hydrolyzed milk formula and finally elemental formula if nothing else is tolerated, although it’s often difficult to get a baby to accept the taste of elemental formula. (2) Today’s elemental formulas all seem to contain corn ingredients, another common allergen, and I’ve worked with families who have had to become very creative in finding a way to keep their very food sensitive baby happily fed. Especially in infants less than 8 weeks, finding some donor breast milk from a mom who is avoiding major allergens can provide a big bonus for the child, helping to speed the recovery of the intestines and provide some more-easily digested and absorbed nutrients for baby who is having formula tolerance problems.
Baby Maven: What percentage of colic and reflux can be cured by eliminating dairy?
Dr. Palmer: With true diligent efforts to find and avoid any irritating foods, it’s well over 90%.
Baby Maven: If a mother is breast feeding, how long would it take to see results with an elimination diet?
Dr. Palmer: Results can be apparent within two or three days or can take up to two weeks. Usually after this point one will want to try a more complete elimination if sufficient recovery isn’t seen.
Baby Maven: How strict does an elimination diet need to be? Can one still have some dairy such as butter or milk cooked in bakery?
Dr. Palmer: Because even trace amounts can cause symptoms in baby, early elimination efforts need to be very strict or the results will most likely not be meaningful. Unless the child’s symptoms were rather mild to begin with, it’s best to stick with strict avoidance for at least three weeks to give the intestines a chance to recover and to reduce antibody levels in the body. After this time, the mother can begin to experiment by adding back a single food at a time and waiting several days to note a reaction. Often if a food is avoided well then one small exposure will not produce any reaction. It may lead to the development of antibodies however and then a second or third exposure within a few days will then reproduce the symptoms.
Baby Maven: In addition to dietary changes, you suggest that certain types of parenting styles may help. Can you say more about what types of parenting styles and techniques can help colicky babies?
Dr. Palmer: Babies are designed to be next to their parents most of the time, both day and night. Carrying, slinging, cosleeping and otherwise fulfilling baby’s needs for human contact can go along way to reduce crying in general. Jiggling or bouncing on a birth ball with a baby helps to add further input and many babies respond positively. It can also help to break up gas bubbles or override pain signals. Some mothers are taught to remove baby from the breast after a designated length of time. Yet, especially for difficult to sooth babies, allowing them to comfort nurse can aid in pain relief and reduces the releases of stress hormones.
Baby Maven: What other less traditional remedies can help?
Dr. Palmer: While the prescription drugs are shown to provide little if any benefit, the more common over-the-counter colic drops don’t seem to do much for most babies either. There are more specific herbal and homeopathic tinctures that may help provide some relief but it’s usually rather mild compared to the level of pain that can develop when baby is not tolerating foods.
There are studies that show that probiotics like acidophilus can reduce some of the actual food reaction. Different studies support different bacteria so I generally recommend just finding a product with a wide variety of bacteria. Breastfeeding moms can increase the amount of these healthy bugs passed on in their milk when they take supplements themselves. Liquid infant versions are available as well.
There are also studies that show that the omega-3 fatty acids DHA and EPA can help reduce a body’s reactions to allergens. Again, a breastfeeding mom can take fish oil or vegan algae extracts herself to increase the levels provided in her milk and liquid infant supplements are available. Consuming the DHA/EPA precursors, as found in flax and walnuts, does not significantly raise end-product levels and is not found to be very effective in studies.
Baby Maven: Is there anything else that parents should know?
Dr. Palmer: In general, breastfed babies have less colic than those fed formula. Many times breastfeeding moms are advised to switch to a hypoallergenic formula for colic but this is very sad advice. First, the baby is being robbed of all the factors that will help his gut to heal; secondly he’ll suddenly be vulnerable to more other illnesses; and finally there are times when none of the formula options work well.
Notes from Baby Maven’s research on colic:
(1) In 1954, Morris Wessel a pediatrician at Yale, introduced the concept of the Rule of Threes noted above.
(2) Up to 60% of those suffering from milk allergies also have soy allergies.
For additional support coping with colic:
1. Access Dr. Palmer’s website: www.BabyReference.com
2. Find a professional (pediatrician, osteopathic doctor, doula, lactation consultant, or other health or mental health professional) in your area who has expertise in colic or pediatric allergies.
3. For breastfeeding mothers, a strict allergy and colic elimination diet suggests avoiding the following for two weeks: All dairy products also called: actoglobulin, Casein, Lactalbumin, Sodium Caseinate, or Whey.
|Caffeine ||Soy Products||Peanuts ||Tomatoes|
|Onions||Green Peppers ||Iron in Prenatal Vitamins |
4. If you are interested in joining a Parents of Colicky Babies support group or would like help coping with colic email firstname.lastname@example.org. As both a professional and the mother of a formerly colicky baby, Carrie’s Baby Maven Services provide support and resources for the entire family.